My 2e son is gifted with ADHD. He has several emotional outbursts (frustration with self, anger at a classmate) per day at school. I thought this would get better over time, and it has. However, it's still occurring with regularity and is disrupting the classroom. This is a Montessori classroom where all is peace, love, and butterflies for most. My son is not reprimanded for these outbursts; his teacher very lovingly helps him through it or gives him space to handle it on his own. Most of the time the meltdowns are related to not being able to finish his work quickly enough (self-imposed standards) or a child has said or done something to which he takes offense ("you're being mean," "you are lying," or "that's not fair" are common statements). Perfectionism is a big problem.

My son is taking a low dose stimulant medication for the ADHD, and it has helped his focus. He could probably stand to increase his dose a little, but he seems to become more emotional when we do so. Anyway, I thought that since the medication is helping with the attention, focus, and impulsivity, it would help with the emotional outbursts as well. While the frequency and intensity of the emotional meltdowns have improved, we're still seeing them on a regular basis. The teacher is concerned and has called a meeting with the guidance counselor, who is very good. The teacher doesn't know what to do, and either do I!

I have been associating the emotional stuff with ADHD. Maybe it's related more to the emotional supersensitivity often seen with gifted children. If this is the case, do you just live with it? Do you accept it as part of your child, or do you try to help stop it? I am at a loss, and I'm so concerned that my son is alienating himself from other children. He is starting cognitive-behavioral therapy this week, and we go back to his doctor tomorrow. I'm concerned that she is going to want to add an SSRI (antidepressant) to his current stimulant med. It was scary enough starting the stimulant; I can't imagine adding another medication. Any experience with this?

Thanks for any advice you can offer. I really appreciate it.

Oh, and one more piece of information: when my son has these emotional outbursts, he initially seems angry, and then it quickly evolves into uncontrollable sobbing. He often makes statements about being stupid or things being too hard. When he's having the meltdown, he describes the feeling this way: difficulty breathing b/c he's holding his breath to try to hold it in, rapid heart beat, feels like he's losing control, his words: "feels like a balloon that is getting too much air and it keeps getting bigger and bigger; the air is pushing against the sides until if finally explodes".

The doctor (developmental-behavioral pediatrician) is concerned that it could be anxiety attacks? She suspects possible Generalized Anxiety Disorder in conjunction with ADHD (and giftedness). She does specialize in treating gifted children with ADHD. After I meet with her tomorrow, she might attribute this to the giftedness, but I could still see her wanting to try another medication in addition to the stimulant. I get the impression that her philosophy is that it doesn't always matter what it's called; what matters is what you can do to help the child feel/perform better.

Hi Jen,
Your description in your second post sounds very much like my DD - she's almost 8 and in 2nd grade.

She has described her losing control as "being trapped in a cage and that a weight is on her" She too starts out VERY angry and then it turns into sobbing and saying the same things about being stupid and/or no one likes her, has no friends, etc.

I'm very interested in what you say about it being anxiety attacks. That is something I never thought of.

Finally, how did you go about searching for a development-behavior pediatrician? This may be a Dr. we may need to see.

Thanks!

Hi Jen,
It is so tough to see your child struggle with frustrations!

It is hard to determine the root cause of his outbursts from a few short paragraphs so I'll share various scenarios regarding this kind of behavior and you can use the info to "peel back the onion" while working with your doctor and school.

Some kids with ADHD and executive functioning challenges have difficulty setting reasonable goals, dealing with frustration, understanding when "good enough" is better than perfect. They can be taught strategies to help handle these situations and set up realistic expectations. That said, their innate drive for perfectionism may still come into play.

One side effect of stimulant medication for some kids is emotional difficulty. While this most often happens as the medication is wearing off, for some kids the medication increases emotional sensitivity. Perhaps you can explore a different medication (as well as dose) - for instance he is on Concerta, switch to Adderal.

As your Dr suggested, perhaps there is something other than ADHD going on. Are you sure the diagnosis is correct and or complete? Things like anxiety, OCD, Bi-Polar often look like ADHD or often present along side ADHD. Could this be a possibility? What about undetected learning disabilities? Sometimes very bright kids mask LD. But, as they are working so hard to overcome, they can get frustrated and overwhelmed. Sometimes they benefit from a structured, explicit teaching approach to help them cope.

How is his sleep, diet, exercise?

I'm glad to hear that you are working with a cognitive specialist and developmental pediatrician. He or she may be able to help you understand the triggers and teach your son to recognize when outbursts are coming on and find strategies to deal with them.

I think you are on the right track. I hope that you get answers and relief soon.

Actually, since he started the medication, his outbursts have gotten better. We do tend to see increased sensitivity, however, when we increase the medication. Without it, he can hardly have a conversation due to distraction and lack of focus. When this happens, we see even more meltdowns. So, the key I think is finding the right balance/dosage.

We have tried multiple medications, and Concerta seems to work the best without increasing emotional lability or causing emotional meltdowns. For him, it doesn't last long enough, and he has to take a short acting booster (Ritalin) in the afternoon, but that's another topic. Some of the meds made him cry all day, as in sad, weepy, and clingy. He could never put his finger on why he was sad. Concerta doesn't do this at all. It just doesn't seem to help him control his frustration.



I honestly believe he has ADHD. What I'm not sure about is if he might have something else going on as well. My husband and I have researched symptoms of everything we could think of, and what seems to jump out at us repeatedly is generalized anxiety disorder. I just hate to over-diagnose him, ya know, especially if it's something he could grow out of or learn to manage. I feel like we've tried everything though. We've also looked into OCD, OCPD, and Aspergers, but the symptoms do not describe him. Anxiety fits the bill, but is it because he is just generally anxious? Is it because he's gifted but also has ADHD so he gets frustrated? He certainly suffers from perfectionism which I know is often linked to anxiety. I just don't know if it makes sense to treat the anxiety or try to "reverse" the perfectionism. Can we even do that?




Sleep is good, diet is ok (he eats healthy foods, but the stimulants affect his appetite a little. He eats a good breakfast and a good dinner, but he only eats so-so at lunch and rarely snacks unless he is home and I can push them.), and exercise is not that great. We can't seem to find anything that he's really into. He's active when given the opportunity, but as for extra-curricular sports, we've yet to find the one he likes and doesn't trigger major meltdowns. He says, "organized sports are just not my thing, Mom." I'm not sure if that's it or if he can't tolerate not being good at something immediately. Also, because of the ADHD, he needs it to really be "organized" or he gets lost. And, if it's too large of a group, he seems to get lost as well. He may just not be ready for team sports at this time. We do try to provide opportunities for exercise though. He gets to swim on a fairly regular basis. He has recess every day at school, although this is his least favorite time of day. He feels like an outsider with the other students during athletic activities. He's pretty small, not all that tough, and gives up way too easily.


Thanks, I am excited to start this. The therapist is someone I've seen for years (off and on since my first husband passed away 7 years ago), and I really trust him. He's wonderful with children and has become a family friend. He used to be a priest, and he even married my second husband and me.

Does anyone know of any books that you'd suggest for practical strategies we can implement at home and that I can go ahead and recommend at school? I am looking for strategies to help my son with ADHD, anxiety, and emotional hypersensitivity.

Thanks Mich! I appreciate the support and advice.

My son is 7, and is in the 2nd grade as well. He often tells us he has no friends and that nobody likes him. Later he'll start talking about a friend at school, so I think he does have friends. The teacher says he interacts just fine. He just speaks in absolutes a lot. If something happens one time, it "always" happens.

I'll let you know what the doctor says about the anxiety and whether or not she thinks these are actual anxiety attacks. When I researched in online, I read in multiple places that in children an anxiety attack can resemble a tantrum.

We chose our doctor based on a recommendation from a friend. We drive about 2 hours to get there. There are developmental-behavioral pediatricians in our area as well, but I felt better going to someone who was recommended. I really like her a lot, and she's good at tailoring the treatment to the specific child. My friend and I have boys the same age with similar issues, however they do have issues that set them apart. The doctor has prescribed different medications based on the differences she sees in our children, and she has made specific recs for each of us. I like this because I find that too many doctors have a one-size-fits-all, cookie-cutter approach to treating ADHD and related disorders.

Try google-ing "developmental-behavioral pediatrician" for your area. Then check for reviews online. You can also ask your regular pediatrician if they have a recommendation. Good luck, and I'll keep you posted on what we find out.

Peace, Love, and Butterflies! We have a 2e child also (but instead of ADHD he has autism) who has similar problems.

I, too, was trying to determine which were due to the gifted OEs and which were due to the autism, but have since given up since the whole package is intertwined. The main thing is that we all work together to help DS have appropriate behavior in the classroom. It doesn't matter what his over-reaction to something minor stems from, but how he can overcome it and get back to doing what he is supposed to be doing with the rest of the class.

Truthfully, I think a lot of his accommodations that he has in place due to his IEP for autism help with his OEs, but I am not going to say that. Do they let you make an IEP for gifted OEs? I don't know and I'm not going to ask to find out. The good news for us is that since he was diagnosed with autism very early (age 2.5) we have had 5 years to work on appropriate behavior...and it has been a LONG road with lots of specialists and therapies.

DS's behavior is not perfect, but I keep thinking what his teacher said this year: he is not her biggest problem. Woo hoo!!!

Anyway, to answer your question, if the behavior is disruptive to the classroom or to your child, I think it should be addressed and not ignored or "accepted." Behaviors that make our DS stand out too much really end up causing him anxiety and turn into a vicious cycle leading to more problems and disliking school.

Nan

Thanks Nanros. That makes sense. What does it matter what we call it as long as we can help, right? That's my philosophy for the day going in to see the doctor. Have a great day!

Yes. Our DS takes an SSRI as well as an attention med. They work very well for him in improving attention (which also helps him not panic in school) and fixing anxiety (which also helps him pay attention).

We found that the stimulant-class ADHD meds ramped DS up too much-- he became edgy and emotional, which made the anxiety worse. We switched him to a non-stimulant ADHD med, which is better for him at this point.

HTH, PM me if you want more details.

DeeDee

I concur that while it is important to question and be vigilant about medication, it is also critical to get the help the child needs. Anxiety and other issues can be debilitating. If medication is the solution or part of the solution, I'd urge you to keep an open mind just as you did with the stimulants. It sounds like DeeDee has some good experience to share. It is always reassuring to know you are not alone.

While you are looking at the medical side of things, I also urge you to look at the learning side. It can be VERY frustrating for bright kids to deal with LD's. Often they are able to compensate and hide LD's, but it comes at a emotional cost. He is only 7 and maybe what you are seeing stems from or is secondary to some challenges in learning. I would seek a full neuropsychological evaluation to help understand his learning profile better. Best case, you don't find any irregularities. Worst case, you identify some areas of challenge are in a better position to address them.

Well, the appointment went well. The plan at this point is to definitely pursue counseling as well as a med change. DS7 took 27mg of Concerta this morning, and while he's not hyper, he's definitely not focused. She commented that in the absence of anxiety, she'd certainly recommend an increase in his Concerta dose to 36mg.

However, she feels that anxiety is a definite, and she spent a lot of time with me and with my son. She also had the teacher, my son, and me fill out questionnaires to help narrow down anxiety triggers and to rule out other diagnoses, such as OCD, OCPD, Social Anxiety, etc. She feels confident in a diagnosis of generalized anxiety. I asked about OEs, and she's of the philosophy that it doesn't matter what you call it. It's still anxiety. She also differentiated between intensities and anxiety and stated that he had both. She said some kids are intense, but it doesn't necessarily cause them anxiety that interferes with function. We also talked about the fact that anxiety and perfectionism are very common with gifted children and can be exacerbated by the ADHD. She recommended some good books as well.

She said we can try the 36mg Concerta for a few days or a week to see if that helps or makes things worse. If this doesn't work, she wants us to try the lower dose of Concerta with Straterra. Of course, he'll be getting counseling as well. She said we can just start with the Straterra and the lower dose Concerta if we are not comfortable with increasing the Concerta. Personally, I'd like to try to increase the Concerta first (small changes before big changes are more comfortable for me!) and then try the Straterra if that doesn't work. I'm not overly optimistic about this, but it's worth a try. At least with stimulants, you know right away whether or not they're going to work and whether or not they're going to cause major side effects.

The doctor thinks that counseling and anxiety management strategies will work well for ds b/c he is bright. She thinks he'll be able to learn the techniques and put them to use. If not, she did say an SSRI could be a next step. However, she also said that studies show that SSRIs are only effective for about 50% of people who take them for anxiety. She believes the success rate is actually even lower than that due to placebo effect. So, we're open to the idea if it's needed, but for now we're going to take baby steps. If we jump to the SSRI, we won't know if it's the medication or the counseling that's helping.

She's not prescribing Straterra for the anxiety. It's to enhance the stimulant if ds is unable to tolerate a higher dose of the stimulant.

So, basically the anxiety treatment will consist of counseling and implementing anxiety management strategies at home and at school.

The doctor loves Montessori education, but she did caution us to be aware of their level of flexibility with skipping steps in the Montessori process. She said even if they allow him to work at an increased rate but still go through every step, this probably will not satisfy him because of his resistance to do things he already knows. Of course, as we know, she said this is typical with gifted students.

She did say, though, that because we live in a less-than-ideal world, it might not be a bad lesson for ds to learn that at times he will be required to go through mundane steps to accomplish a task. Her measuring stick with regards to how much of this he can tolerate is to see whether or not he wants to go to school. If he's happy, likes school, and continues to want to be there, then that's a good sign. If he begins not liking school and not wanting to be there, that's a red flag, and we might want to consider other school options. I will be talking to the teacher, counselor, and administrator (headmistress) about acceleration, however.

Now, speaking of acceleration and neuropsych testing, what would you guys recommend? We are open to a complete battery of tests if that's what it takes to get ds the education he needs. Public school is not an option here unless we can move. And, in this market, that's not happening anytime soon.

I'd like to do more gifted testing as well. It's been a couple of years since his last testing, and he was not on medication at that time. Also, I'd love to know if there are any LDs going on. I really don't think so, but I know sometimes with bright kids, it's not immediately evident.

What do you think about achievement testing to help with grade-level/academic-level placement? Any suggestions? I feel like the teacher is probably thinking it doesn't make sense to increase the challenge if he can't do the easy work. I know that logic makes sense with many children, but not with my ds and not for most gifted children. I don't know how they will be able to know what level he is in any given subject. Is there some kind of test?

For example, he can add and subtract, of course, but he's not super fast with it, so he hasn't been allowed to move on to multiplication or division. When I was homeschooling, he was able to do multiplication and long division. "After-schooling" is a nightmare b/c by the time he gets home in the afternoon, he's very resistant to anything academic. Plus, we're paying out the nose for this school; my son needs to be learning something. This was something I had a hard time with when homeschooling. I didn't know how to move in any kind of logical order, especially with math, because he's capable of so much but limited by his interest level. Does that make sense? Ok, I'm rambling. Long day...

Thanks guys for all the support and advice. It's been a huge help.

Hi Jen,

Your DS sounds rather a lot like mine in the pairing of anxiety/perfectionism with attention issues that lead to upsets at school. Ours has Asperger's, so YMMV for anything I say.

Your current treating professional--psychiatrist?-- what kind of testing information is she operating with in making her decisions? Some questionnaires, or something more rigorous? Is she a specialist in ADHD/gifted?

For our DS, to diagnose the Asperger's, they did a full neuropsych workup. This included unbelievably detailed developmental history, questionnaires for us and teachers, IQ testing, academic achievement testing (you asked about this--it measures what he knows), language testing by a speech therapist, the ADOS (autism rating scale), Conners' rating scale, the Vineland test of adaptive skills, and more. Close to two full days, with breaks. (We were lucky this was covered by insurance.) After which we came out with an incredibly detailed picture of strengths and weaknesses, including the giftedness and the social deficits and the rest.

I think if you're not sure what's going on with your DS in addition to the ADHD, this kind of testing is probably a smart idea-- if your tester is really sharp, they can tease out what the precise issues are, which can affect your decisions. Yes, ODD, ADHD, and AS can all look quite similar, or be comorbid, and some of the treatments are the same, but some of it's different, and you'd want to know what you're treating. I'd be very careful about choosing a tester, to find someone with LOTS of experience with 2E kids.

The achievement testing would let you and the school understand what work your DS can actually do, and the IQ testing might indicate his potential-- then you can start to make decisions about what's appropriate for him. Coming at a school with data is very different than just saying "but I know he's smart" when they are having a hard time seeing it themselves.

My DS hated homework, too, because he resented school so much in grades K-1. This has gradually improved with loads of positive reinforcement and treating the anxiety.

Nailing down the gifted numbers with IQ and achievement testing turned out to be important for us; getting DS placed correctly in school has helped him be happier, though it is not even remotely a cure-all. Anxiety is real, and it takes a lot to change those thought patterns.

I will say that for us the SSRI was extremely important. DS could not even access the therapies for improving his thinking around anxiety until we got him down from fight-or-flight mode with the meds. Once he was feeling calmer and more rational, the cognitive therapies "took" much better.

We also believe that DS was suffering tremendously. He sure wasn't wanting to have all those panic attacks, especially at school where it was embarrassing to be out of control, and it became imperative that we treat the anxiety by any means necessary. For us, anxiety interfered with learning.

We have found a developmental pediatrician who specializes in AS who gets the gifted piece and is reasonably conservative in her approach; she talks to us and DS for a long time before any change in meds, and has vastly improved our lives. YMMV.

DeeDee

My DD just turned 8 and sound very similar to yours in so many ways. She is PG, has ADHD and her perfectionism is crippling. She doesn't want to do work that is too easy because it is 'boring' and she won't dare attempt anything hard because she can't do it as well as she wants. Her anxiety is a huge issue right now. If you have any good anxiety management strategies to share, please do. DD is also seeing her psychologist regularly.

I don't have any advice to share.. I wish I did. Just wanted to let you know that there are people with similar struggles. It is incredibly hard to send my girl to school each day and know how hard it is for her. I just want to fix it and I can't.

Aside from the meds (discussed earlier in the thread), we have taken several approaches to anxiety management. This is a work in progress for us.

Part of the problem is that gifted kids are so unused to making mistakes in school that they don't really understand that everyone does all the time, that it's totally OK. It is important in school to be working right at the child's point of difficulty-- where the work is possible for them, not too hard, but hard enough that mistakes will happen-- so that they can have this experience. Our teachers are working on giving DS supportive feedback about mistakes that emphasizes that this is normal learning.

Some of what we do at home is problem-solving training in general: "OK, it's not right, how can you fix it to make it right?" Not only for academic work, but for any situation-- a dead battery in a toy, a ripped piece of paper, anything. Feeling like you can have another go at something, or repair the mess you made, is useful.

Part of it is just having more experience in accepting undesirable outcomes graciously. We praise DS when he makes a mistake and deals with it, or copes with adversity, and we explain why this is important. We play games where everyone loses sometimes (games of chance, and games of skill, both, and we talk about the difference)-- and we practice losing graciously at both kinds.

We parents also routinely point out when we make mistakes. Sometimes I make a wrong turn on purpose in the car, just so I can model that it's no big deal, I'll just go back the other way and the mistake will be fixed.

And we often emphasize process over product--"You did that really well, you must have practiced"-- if we know he did practice. If someone's better than he is at something, we suggest they might have practiced a lot, or have a talent for it, or both. He gets praise from us if he notices and compliments what others do well.

All of this is having some effect, though it is going to take a long while to make it part of his operating system.

DeeDee

Thank you guys. I am so tired, so hopefully I'll make sense tonight! First of all, we have had gifted testing done, but I'd like to have it done again now that ds is on medication and can focus better. Deedee, thanks for clarifying what all is involved in a more comprehensive assessment.

The neuropsych testing sounds like the way to go, but I'd really like to find someone good. I've been searching, and I can't find anyone who specializes in working with 2e or gifted children in my area. We'd be willing to travel if necessary to see the right doc. We just want some answers. I'd hate to think my son is continuing to struggle simply because we're barking up the wrong tree.

If anyone has a neuropsychologist they'd recommend, please PM me!

Our doctor is a developmental behavioral pediatrician who specializes in giftedness, ADHD, and ASDs. I love her, and I am repeatedly impressed with her level of knowledge of treating 2e children. She used our gifted testing results/report, developmental testing done at her office (I'm not sure exactly what this entailed, but it was definitely not all that is done in a neuropsychological eval.), a very thorough history (I was digging up my baby books and calendars from my son's first year, reports from teachers, family history, etc.-took a very long time), physical tests with my son, and questionnaires from my husband and me and the teacher. These were also very long and detailed questionnaires. She has follow-up questionnaires that we and ds's teacher complete periodically to measure progress, but these are only a page or two each.

Deedee, our doc recommended many of the strategies you mentioned. I can't believe I never thought of playing a game that didn't have a winner or a game where the loser actually gets a prize. I guess the idea is to dis-associate losing with an extreme negative feeling and replace it with a positive. That way the child can focus on the process and enjoy the game rather than worrying about the outcome.

I read in one of my books today that another good technique for kids who have difficulty with team sports due to anxiety (my son) is to use team-building activities. This would be good for siblings, classmates, or club members to do together (like the things office employees will do together for team building). They all have to work together to complete a task or reach a goal, but they are not working against anyone. I'm going to talk to my son's teacher about trying to incorporate some of these kinds of activities into recess.

Right now, ds wanders around looking for an activity that appeals to him, and is intimidated by trying to interject himself into other kids' games. He ends up doing nothing and is planning to ask his teacher if he can just bring a book to recess.

Kathleen'smum, thanks for sharing. It REALLY does help to know you're not alone. I'm sorry your child is experiencing the same struggles. It's very upsetting not to know how to help your child. We're doing our best and searching for answers, though, right? My son tends to be a happy little guy most of the time, so I know I should count my blessings. I just hope we can get a handle on what's going on with him so he can feel good about himself all the time! Good luck to you too. Hopefully some of the info here will help.

Thanks Deedee and everyone for your help. I'd REALLY love to hear suggestions or neuropsych recs. Thanks!

Jen, since you already trust your dev. beh. ped.-- how about asking her for a recommendation?

DeeDee

I will definitely do that. I wish I had read your previous post before I was there today. ; )

I am planning to call tomorrow. I just have my doubts that there will be anyone experienced with 2e children. Hopefully I'll be pleasantly surprised.

Thanks again. Good night!

Well, I called the doctor, and she only had one recommendation. The neuropsych she recommended is near the pediatrician's office (2 hours away), and she only recommends her b/c she's really the only one around.

So, I checked in my area, and I found a couple, but none of their websites even mention the word "gifted". I don't know what to think about that. I called one today, and she said she'd be happy to sit down with me for a one-hour consultation, look over the previous testing/evaluations, and recommend (or not) further evaluations. Is this typical?

Also, I was looking over ds's gifted testing again, and he has a 24 point difference in his verbal IQ and his nonverbal IQ scores. The verbal was higher. Could this indicate a nonverbal learning disability? I did a little research on it, and some of the characteristics fit, but some do not.

When the testing was done (age 5), I discussed the results with a gifted teacher friend of mine (who also has gifted children of her own) and she pointed out the discrepancy, suggesting a possible LD. I asked the psychologist who did the testing, and he said LD was unlikely because both scores were considered advanced. Now I'm wondering if he just didn't have enough experience with 2e kids.

Any experience with this? I'd love to hear what you all think. Thanks again.

Oh, wow, that's tough.


Sounds like an OK deal, actually; you'll get a sense of whether she asks the right questions and starts to build a correct picture of your DS before investing in hours of testing.


This is out of my area of expertise in terms of technical understanding of the tests. (Dottie?)

But based on our own experiences it does happen that doctors overlook problems because the scores overall are so high that you "ought" to be delighted-- even though those dips (the places where a gifted kid is merely average instead of outstanding) can indeed indicate a real and treatable problem.

Since you're seeking a second opinion, it's a good chance to revisit this explicitly. I'd ask specific questions about this in the consultation if you go that route.

DeeDee

DS did great on the new med dosage! I'm keeping my fingers crossed that tomorrow will be another good day. He even went to piano and counseling after school. We didn't get home until 6:30. He ate dinner, and then did his homework at 7:15. He finished his homework in less than a half hour and didn't complain once.

He had to write sentences with his spelling words. Usually, he tries to think of the shortest sentences he can so he doesn't have to write so much. Tonight, he was adding to the sentences to make them more interesting and working at a very good pace. After homework, he went to bed, we read a few pages of Harry Potter, and he was off to sleep. Not one meltdown all day!

He absolutely loved his after-school piano lesson and was focused the whole time. The counseling session went well. It was our first one, and I think we accomplished a decent amount in just one session. It's definitely a work in progress, but it's a good feeling to have such a positive day.

I was concerned that the increased dosage of his stimulant would exacerbate the anxiety or make him emotional. That didn't happen at all. And, I am very relieved that it didn't affect his personality. He was calmer but still had a good bit of energy, was not lethargic or tired, and was his normal happy self.

Our family, including ds, needed a really positive day, and we are very grateful. I might even sleep tonight. ; )

High-five !

Thanks guys! I actually just got even better news. I just found out that ds didn't get his afternoon booster at school for the past two days. So, (fingers crossed) maybe he just needs that increased concerta (36mg) in the morning and no booster (at least not every day). Usually he needs a booster by 1 or 2pm. I actually thought he'd had a 10mg booster yesterday because we were planning to increase that dosage as well. Turns out, he did that well with just the concerta! Great news; praying today is just as good.

Btw, our counselor suggested we wait a month or two before doing any further testing. I think he's afraid we are looking at the challenges without considering the big picture. He said,"I'm not discounting the possibility that there could be a LD or other issue going on, but I think we should address one thing at a time right now." So, we're going to focus on getting the ADHD medication dosage straightened out while continuing therapy and piano (an activity he actually loves! finally!). If we do not see improvement or ds is showing academic problems, we'll pursue further testing. I have a tendency to jump the gun because I'm afraid of letting something slide. I'd hate to think he had a problem and I didn't address it early enough. As always, I'll be keeping a close watch on what's going on and recording a diary of daily observations and notes from the teacher. I am going to try to take a break from reading about disorders because every time I read about a new one, half the symptoms apply to my son! They overlap so much it's hard to know, isn't it?

http://www.nldline.com/giftednl.htm

Interesting article.

That is good news. Good for you for taking that perspective.
Hugs,
Grinity

Great news! What a relief to know you are on the right track with the medication and dosage.

Sounds good, Jen. Glad to hear of the progress!

DeeDee